Tell Your Stress Goodbye With These 9 Amazing Foods

These days, we have a lot of stressful days at work or home. Every day, we get deadlines to meet and a new problem to resolve. Different studies have shown that your diet can influence your stress level. Hence, eating smart can help you relax and deal better with hectic situations.

While there is not a cure-all food to magically remove stress and frustration, you can get some stress relief with a combo of exercising, eating small meals throughout the day and getting more of these fresh goodies.

  1. Dark Chocolates

Dark Chocolates are considered as one of the best solutions to reduce the stress level. A study was published in the International Journal of Health Sciences that says that the polyphones contained in cocoa beans cut the stress hormones in the blood. So the next time you are feeling stressful and a lot of burdens, try a piece of dark chocolate melting on your tongue.

  1. Blueberries

Blueberries are high in anthocyanins that are able to reduce stress. It also contains vitamin C, which boosts your immune system. Blueberries are particularly important for people who are constantly stressed tend to be sick more often.

  1. Tea

Tea is considered as the best solution when you are feeling sleepy, calm frazzled nerves with a steaming cup of your favourite tea blend. The soothing warmth and tea’s plant compounds work together to level off your body’s response to stress.

  1. Milk

A glass of milk is great in getting more B-vitamins, protein, vitamin D and bone-building calcium to relieve tense muscles. Make sure to stick to the low-fat (1%) or skim varieties. If you like to add more flavour in your milk, have some with whole-grain cereal in the morning or sip on some chocolate milk around bedtime to bring on more restful sleep.

  1. Banana And Avocado

Banana and Avocado are loaded with potassium, a vital mineral; it amazingly keeps the blood pressure low. To make the food interesting, add sliced banana to your morning oatmeal or a half-cup of sliced avocado to a lunchtime salad or sandwich.

  1. Fatty Fish

The heart-healthy omega-3 fats in fish such as salmon, sardines, and tuna manage adrenaline levels to support keeps you calm, cool and collected. Fatty Fish is also awesome for just about every part of your body like eyes, skin, and hair.

  1. Green Leafy Vegetables

We are aware of the advantages of green leafy vegetables; they are lighter on calories and also better for your figure. Besides, green leafy vegetables like spinach contain folic acid. The human body needs this B vitamin to make the neurotransmitter dopamine that can support relieve and ease symptoms of depression.

  1. Carrots

Now, forget about pizza and other crunchy foods, try carrots to beat the stress. Carrots are nutrient-rich and are able to offer satisfying crispness.

  1. Nuts

Different types of nuts like almonds, pistachios, and walnuts are high in the antioxidant vitamin E and zinc that is effective in boosting your immune system.  Those nuts are rich sources of B-vitamins, which help the body manage stress, too.

Senate Bagged Healthcare aid for Marshallesa

OLYMPIA – For Doresty Daniel, Thursday was “the greatest day of my life.”
The Washington state Senate had just passed a bill to provide health care to Marshall Islanders who are residents of Washington, a measure designed to help the Marshallese who suffer health problems from nuclear tests the United States conducted near their islands in 1940-50. “It means that our people can go out there now, without being afraid of going to the doctor because of (the cost),” said Daniel, a Spokane resident and school district employee.

The bill would allow more people from countries belonging to the Compact of Free Association – an international agreement between the United States and the Pacific Island nations of the Marshall Islands, the Federated States of Micronesia and the Republic of Palau – to receive health insurance.
The Health Care Authority would pay for premiums and out-of-pocket costs of individuals who are citizens of a COFA nation and current Washington residents, with incomes at or below 133 percent of the federal poverty level.

The bill’s sponsor, Sen. Rebecca Saldana, D-Seattle, said the islanders have experienced negative health impacts from the testing, including cancer.
“We’re making right of a past wrong and making sure they have access to health care for their families, for their children and especially for their elders,” she said.
Sen. Bob Hasegawa, D-Beacon Hill, said Washington has a moral obligation to the islanders, who were used as “human guinea pigs” to test the effects of radiation.
“This case is one of the most egregious examples of where we really need to step up,” he said.
But Sen. Jan Angel, R-Kitsap, said the bill does not address the many other Washington residents who pay insurance premiums that are too high, especially young families and single mothers.

“I’m struggling with taking one group of people and singling them out with these benefits,” she said.
Sen. Ann Rivers, R-La Center, said she supports helping the islanders, but is concerned Washington will become a magnet for financial burdens that are the federal government’s responsibility.

“We’re being the adults in the room, and we’re taking care of these people,” she said. “(But) Washington state can’t fix all of Washington, D.C.’s problems.”
Emtison Nyberg, a Marshallese Spokane resident, said she felt like crying with joy when the bill passed. It especially will help seniors like her mother, who does not have insurance and was previously unable to seek help for a bad leg, she said.
“We’ve been waiting for this for a long time,” Nyberg said.

Healthcare Groups Refined the Single-payer System in California

The focus of the testimony was SB 562, a single-payer bill that was approved last year but then shelved. The bill would establish a system by which the state would pay for all healthcare and essentially cut out insurance companies. Taxes would increase, but supporters maintained that would be offset by the elimination of insurance premiums, copays and other costs.

There are some legal hurdles that would make switching to a single-payer system difficult, according to a report from local public news outlet KPCC. The rules that govern the Affordable Care Act, for example, are all federal, so any changes would require negotiation with the U.S. Department of Health and Human Services.

California’s Medicaid program, Medi-Cal, relies on both state and federal funding, and the feds have the final say. Plus, there’s Medicare: It’s a federal program, so California can’t make changes to eligibility, financing or benefits without a thumbs-up from Washington.

There are also a couple of state laws that would make things thorny — such as Prop 4, a 1979 law that limits how much tax money the state can keep. Above a certain threshold, funds have to be returned to taxpayers, and it would require an amendment to the law to make healthcare exempt.

Supporters of the bill, including the California Physicians Alliance, say it would be worth the effort. One of those supporters, economist Robert Pollin of the University of Massachusetts Amherst, told the committee Wednesday that the state would have to raise about $100 million in additional funds to cover the cost of single-payer, but that most in the state would end up paying less for healthcare because insurance-related expenses would be eliminated.

Other supporters include Health Access California, the California Immigrant Policy Center, Small Business Majority and the California Labor Federation.
Opponents of the bill — including the California Chamber of Commerce and the California Medical Association — say there’s no responsible way to pay for a single-payer system.

The committee is expected to produce a report by this spring with recommendations on how to proceed.

Billionaire Punjabi Brothers Resigned From Fort is Healthcare Board

Billionaire Malvinder Mohan Singh and his younger brother Shivinder Mohan Singh, founders of Fortis Healthcare, resigned from the company’s board on Thursday. A late night Bombay Stock Exchange (BSE) filing announced the stepping down of the promoters.

“…we believe this is in the interest of propriety and good governance. It is intended to free the organization from any encumbrances whatsoever that may be linked to the Promoters,” the brothers wrote in their joint resignation letter to the board of directors.

Their resignation from the Fortis board happens days after the Delhi High Court upheld an international arbitration case award of Rs. 3,500 crore to Japanese company Daiichi Sankyo against them.The brothers said they are resigning to ensure the company is insulated from this ongoing legal fight.
ENTS
The Singh brothers were also the founders of the pharmaceutical company Ranbaxy. They sold their stakes to a Japanese drugmaker for $2.4 billion in 2008. Shivinder Mohan Singh founded Fortis Healthcare with his elder brother Malvinder in late 1990s.

It’s time for SA to embrace a new healthcare model

The National Health Insurance (NHI) is not a radical shift to dismantle a functioning system, but an opportunity to review two poorly functioning ones. The public sector sees very high volumes of patients but gives them bad service and produces very poor outcomes. The private sector is modeled on low-volume, high-cost care — it uses its huge quantities of resources badly, to service very few people.

As the health market inquiry report makes clear, the large, commercial medical schemes are resisting needed reforms which, with better productivity, would lead to the convergence of the two systems. In particular, they persist with an outdated tariff system that pays for services, not outcomes, and doesn’t support team-based delivery models. This is probably because it threatens their claim payment and “managed care” models that justify a very high income. This strategy is

counterproductive for their members.
SA cannot move forward socially or economically without convergence. We need a high functioning universal healthcare system — one that can provide high volumes of quality care at low cost. One that uses all available resources, assigns funding according to need and rewards value (the best outcomes, at the lowest costs) when it is delivered.

The challenge for all stakeholders is how best to transition to such a system,  one that places patients at the centre of its model, with service by multi-disciplinary teams providing continual and proactive care. The transition must be compelling and safe for clinicians. It must be an attractive vision, have realistic milestones and pose no threat to clinician income. It must produce a system that is affordable for all South Africans.

No value for money
This is what the NHI proposes to do: it has as its premise the separation of the supply of healthcare from the role of an agency purchasing it, in line with international best practice. Since 2000, medical schemes have been cast the role of purchaser, but none has taken it beyond pursuing good prices from providers. Instead of actively commissioned, new, highly productive models, they have overseen rapidly rising premiums. The health market inquiry report vividly describes how schemes have failed their members by not buying overall value for money, despite the reform road being perfectly clear.

The purchaser role put forward by the NHI is the proper one, however, with providers competing for contracts from a large purchaser based on the value they deliver. It sets out to quickly drive vast improvements in how care is delivered to bring down the cost of comprehensive medical care. It plans for a major shift towards community-based care, instead of today’s hospital plans. And it supports widespread multi-disciplinary teamwork, a much more effective and cost-efficient model.

The NHI is not a move to dismantle the commercial sector, it’s a call to action for much-needed reforms. A commercial sector that offers high-value services will provide them for an NHI purchaser, which has no preference for publicly owned, commercial or not-for-profit providers. Made subject to market competition, public-sector services will need to tremendously improve their delivery of care or face losing their funding.

We need to acknowledge that, as it currently stands, neither system produces good value, essentially because they are badly structured. They are built around the convenience of clinicians — bringing sick patients to multiple hospitals, clinics or private rooms for care. Doctors are paid and work as individuals, which hinders multi-disciplinary input and results in reactive rather than proactive healthcare. Both systems have poor process management, which cannot manage patients with multiple problems. In different ways, both have badly misaligned incentives for the practitioners who work within them.

Healthcare stakeholders must get out of the weeds and stop resisting change by disputing unspecified details of the proposed NHI. Stakeholders should be urged to rather embrace the NHI framework as a step in the right direction, one that will spur the sector to action, and out of its current stasis.

Update 2018: Healthcare Tempo in Malaysia

The demand for healthcare is rising and continues unabated, with opportunities for improvement and innovation in diagnoses and treatment. However, economic uncertainties and budgetary constraints continue to put significant financial pressures on the provision of healthcare services.
The net impact of these contradictory pressures is uncertain. What will Malaysian healthcare be like in 2018?

Impact on Patients
The Federal Court reaffirmed in Kok Choong Seng & Sunway Medical Centre v Soo Cheng Lin in 2017 that the legal standard for the provision of information to patients is the Rogers v Whitaker principle, i.e. doctors have a duty of care to disclose material risks.
A risk is material, if “in the circumstances of the particular case, a reasonable person in the patient’s position, if warned of the risk, would be likely to attach significance to it, or if the medical practitioner is, or should reasonably be aware that the particular patient, if warned of the risk, would be likely to attach significance to it”.

Although this patient-centred standard has been around since 2006, many healthcare providers still do not understand their legal duties, with some of them having been held liable by the courts for their failure to inform.
Patients’ voices will become louder in 2018 as they are increasingly more informed, particularly from the electronic media – although the quality of health information on the Internet is variable.

The Malaysian Health Data Warehouse (MyHDW) was launched in April 2017 with the objective of using Big Data for analysis and decision-making, with the potential for reducing cost, reducing waste and optimising the use of limited resources.
The collection of personally-identifiable data is unavoidable. Questions about data security, its de-identification when released to users, and oversight of MyHDW have not been clarified.

With the reported leaks of the personal data of mobile phone subscribers, organ donors and members of medical organisations, patients need assurance that their health information is always kept confidential. Interestingly, the Personal Data Protection Act does not apply to the public sector.
Public trust in allopathic healthcare delivery systems continue to wane. Many people willingly entrust their healthcare to the non-health sectors with technology providing them the tools to do so, e.g. refusal to vaccinate, home deliveries by unregistered personnel, and purchase of unlicensed medicines unavailable locally through the Internet.

The public will increasingly demand to be treated as human beings with better patient experiences enhanced by providers, and not as entries in medical records. The demand for patient safety and quality of care will continue to pressure regulators and payers to ensure that the healthcare services provided are safe and of high quality.

Increasing Healthcare Expenditure
Healthcare expenditure will continue to rise because of the ageing population, the double whammy of non-communicable and infectious diseases, new technologies and increasing patient demands.

The need for long-term care and non-communicable disease management will increase for the senior population and an increasing number of young adults. This is inevitable as large segments of the population are unhealthy with diabetes, hypertension, overweight and obese.

Concomitantly, infectious diseases, especially dengue, will continue to plague the public. Despite vector control measures, dengue and malaria prevail with no cure for the former and increasing drug resistance in the latter. Some previously-eradicated diseases like rabies are also making a comeback.

There will be increasing out-of-pocket expenditure in the private sector, and even in the public sector, particularly with increasingly expensive medications and procedures. An increasing number of people will face financial ruin if they or their relatives get catastrophic diseases like cancer and heart attack.

Medical inflation will continue to exceed the increase in GDP (gross domestic product). Cost containment in private hospitals has not succeeded.
The Private Healthcare Facilities and Services Act regulates doctors’ professional fees, which comprise not more than 20%-30% of the private hospital bill, but hospital charges continue unregulated. A RM100,000 private hospital bill, which was uncommon at the beginning of this decade, is now common.

Concomitantly, charges in private clinics, and even in private hospitals, are increasingly being capped by managed care companies and third-party administrators. More general practitioner clinics will close, primarily because of financial unsustainability, and rarely because of retirement.

When middlemen take a share of the healthcare ringgit, compromises are inevitable, with consequent impacts on safety and quality of care. Studies about a national health financing scheme have been on-going since the 1980s. Although voluntary health insurance was announced in October 2017, details are yet to be disclosed.
Private practice for public sector specialists may or may not stem the outflow to the private sector, as the outflow is often due to service conditions and not just financial compensations. Would the care of public sector patients be affected by such private practice? Only time will tell.

Medical Workforce
There are too many medical schools, too many graduates, and too few house and medical officer posts. Over-production of the medical workforce continues although the public is wiser, with decreasing applications to private medical schools, which will lead to mergers, acquisitions and closures of some.
The crunch will come in 2021 when the four-year contracts of the initial cohort of junior doctors in the Health Ministry will end. Some will continue to be employed, but the rest will have to find their way in the saturated private sector or seek alternative employment.

Delays in the appointment of housemen after graduation from medical schools has led to some of our best and brightest doing their housemanship training in regional countries that provide certainty of appointments. Training doctors at taxpayers’ expense for other countries is, to say the least, illogical.

Medical Technologies
Healthcare has lagged behind others like telecommunications, transportation, retail etc, in utilising new technologies like artificial intelligence and virtual reality.
The smartphone, portable or at-home diagnostics, smart drug delivery mechanisms, digital therapeutics, genome sequencing, machine learning, blockchains (decentralised databases) and the connected community will begin to impact on multiple aspects of healthcare delivery, e.g. operations, workforce management, business models, patients’ confidentiality and security.

Stay Healthy
Staying healthy is critical to avoid receiving healthcare. A healthy diet, maintaining an appropriate weight, regular exercise, sufficient rest, safe sexual practices, avoiding smoking, moderate alcohol consumption and keeping vaccinations current are some of the measures to stay healthy. This requires some work, smart lifestyle choices and the occasional medical check-up.
Wishing all readers good health in the Year of the Dog!

The way to Amalgamate Cancer Care

Taking stock of new evidence in the field and building on previous ESMO statements and dedicated Clinical Practice Guidelines, ESMO is calling attention to the evolving and growing gap between the needs of cancer patients and the actual provision of patient-centered care from the time of diagnosis, including supportive, palliative, end-of-life and survivorship care.

“New studies in the field of supportive and palliative care show that there may be a gap between what doctors think is important or disturbing for patients, and what patients really need.

“With this new position paper, we wanted to call attention to the fact that, as well as anti-tumor treatment, cancer patients need physical, psychological, social and spiritual support, at every stage of the disease from diagnosis. We refer to this as patient-centered care,” said Dr Karin Jordan from the Department of Medicine V, Haematology, Oncology and Rheumatology, University of Heidelberg, Germany, and ESMO Faculty Coordinator for Supportive and Palliative Care, ESMO Clinical Practice Guidelines supportive care section subject editor, and main author of the paper.

She continued: “Patients must ‘set the tone’ in supportive and palliative care. We need to make it easy for them to tell us how they feel, what they need, and of course, allow them to be fully involved in decision-making if we are to provide optimal patient-centred care.

“The concept of patient-centred cancer care is described in this paper (encompassing both supportive and palliative care), along with key requisites and areas for further work.

“We chose this term because we believe in a continuum of care focused on alleviating patients’ physical symptoms and psychological concerns.”
Dr Matti Aapro from the Cancer Centre, Clinique de Genolier, Switzerland, and co-author of the position paper, ESMO faculty member and past president of the Multinational Association of Supportive Care in Cancer (MASCC), said: “Recent studies show that palliative and supportive care not only improves treatment, it also contributes to better use of existing resources, avoids waste, and may ultimately also reduce the cost of treatment.”

The ESMO Position Paper states that individual cancer patients will express different physical, psychological, social, existential and spiritual needs at different stages of the disease, that will often evolve over time.

Therefore, patient-centred care cannot be standardised, even though it is provided through a standard framework.
Patient-reported outcomes (PROs) should be highly encouraged as requesting them has been shown to be associated with better quality of life, fewer hospitalisations, and even increased survival, compared with usual care.

“A cancer diagnosis, the disease itself and the effects of anticancer treatment are major stress factors for patients. Around 14 million people are diagnosed with cancer around the world every year,” explained Dr Jordan.

“Over the last decade, clinicians have accepted that, while survival and disease-free survival are both fundamental factors, overall quality of life is also crucial for patients.

“Patient-centred interventions should be routinely discussed and evaluated by the multidisciplinary team (supervised by the oncologist) together with tumour directed treatment,” she said. “Of course, patient preferences and cultural specificities should be respected.”

“We hope that this paper will contribute to develop a generalised culture and acceptance of supportive and palliative care, worldwide,” said Dr Aapro.
“Basic patient needs such as pain relief are still not being widely met. Education is vital to make sure that essential supportive care is accessible to all cancer patients, everywhere.

“Quoting Dorothy Keefe, past MASCC president, I would say: ‘Supportive care makes excellent cancer care possible’.”
“ESMO is committed to increasing awareness and education to bring patient-centred care closer to all professionals; to improving collaboration between healthcare providers for the good of patients; and to promoting research, so that patient-centred interventions are not only integrated, but also based on the best evidence,” said Andrés Cervantes, chair of the ESMO Educational Committee.

“Despite growing awareness of the need to develop patient-centred care and recent progress in the field, more and better scientific evidence is required so that effective interventions can be proposed to cancer patients at each stage of their illness,” said Dr Jordan.

“This paper is important because it takes ESMO’s long-standing interest in supportive and palliative care – shown, for example, in its Designated Centres of Integrated Oncology and Palliative Care accreditation programme – a step further.

“Developments since the last ESMO position statement in supportive and palliative care in 2003 show that, not only do these interventions improve patient’s quality of life, but also, overall outcomes.

“ESMO appeals to health authorities in Europe and beyond to ensure that cancer patients have equal access to the best possible patient-centred cancer care that resources allow,” she concludes. “This is a medical and ethical imperative.” – ESMO

Strength to Talk about Mental Health

According to Malaysia’s National Health and Morbidity Survey 2015, mental illness is expected to be the second biggest health problem affecting Malaysians by 2020. It’s estimated that one in three people will suffer some form of mental health issue such as anxiety, stress or depression in their lifetime.

While the projection seems bleak, there are many organisations and initiatives geared towards alleviating the problem.
What’s difficult to manage, however, is that people often find it hard to open up and talk about their mental health issues, particularly within a culture that puts a premium on saving face. Traditionally, showing emotions has been viewed as a weakness that demonstrates a lack of resilience.

As a teenager, I had a fascinating conversation with my granddad that has stuck with me ever since. He was a burly man even in his 60s and 70s, and certainly no weakling. I asked him about the idea that “boys shouldn’t cry” and received an unexpected response from the ex-army man.
He told me, “People say crying is a weakness and only girls should be allowed to cry. But crying isn’t a weakness, it’s a strength. It takes a lot for a person to show how they feel.”

I pressed him and asked, “But if crying is a strength, why do people say we shouldn’t do it?” He replied: “Because people don’t know how to deal with feelings – and that’s a weakness.”

At the time I nodded along sagely, but it would be years before I had a real understanding of what he meant and how it affects mental health.
In life, we have order and chaos. Rational thought, rules, etiquette and composure exist within an order that we easily understand and happily work with. Whenever order is broken, it’s difficult to make sense of chaos. Rather than make sense of it, it’s easier to dismiss it as quickly as possible.

The understanding of how minds work is in its infancy. What we don’t understand, we fear. If we break an arm, people know how to fix it. If we get anxious or stressed, they feel less equipped to support us in dealing with our mental health.

Nevertheless, most people experience anxiety, stress, depression and trauma at some point. Some suffer more than others. Recently, I corresponded with a young woman about her anxiety. She lost her father unexpectedly a few years ago. In her struggle to cope with her grief, she found her self-assurance and confidence had left her.

Though she can “put on a brave face” to help her get through the day, she finds herself in a constant state of struggle. Like many, she tries hard to suppress the difficult emotions. Sadly, this serves to compound the suffering that always finds some way to manifest itself as a mental health issue. It’s sad to hear people say that they don’t wish to be a burden on their families, but it’s an understandable reaction given that so many are uncomfortable with conversations about grief, stress and trauma. Nonetheless, it’s something we should address. We can start by asking “How are you?” of those around us, and showing that we are genuinely willing to stop and listen to what they have to say. Burying our heads in the sand is a dangerous strategy that has long-term implications for the mental health of our family and friends. We also miss out on one of the most precious aspects of life – forming an authentic, deep connection with the people we love.

When we courageously open up to each other, we create an opportunity to share our troubles and give each other permission to reveal our true selves, ultimately strengthening our bond considerably.

In his 2013 book The Trauma Of Everyday Life, psychotherapist Mark Epstein notes, “When we stop distancing ourselves from the pain in the world, our own or others’, we create the possibility of a new experience, one that often surprises because of how much joy, connection, or relief it yields. Destruction may continue, but humanity shines through.”

Buddhist teacher Thich Nhat Hanh suggests that the greatest gift we can give is our presence. Feelings of loneliness, isolation, and being misunderstood often stem from our struggles. Being present for our family and friends can significantly reduce these struggles. We should never underestimate the difference that being there for someone can make.

Finding the courage to have genuine conversations might initially feel uncomfortable, but so much can come from going beyond the small talk to find out if someone is really OK. Having just one conversation can reaffirm a deep level of love and support. It could be enough to ease the heaviness of a person’s burden and save their life.

Stop the Storm of Diabetes

The body’s blood sugar is controlled by insulin, a hormone produced by the pancreas in the abdomen. Insulin acts on food in the bloodstream to move glucose into cells, where it is broken down to produce energy.

Diabetes is a chronic condition in which cells are unable to break down glucose into energy. This is due to insufficient production of insulin or the insulin produced does not function properly. The former, which is much more common, is called type 2 diabetes, and the latter, is type 1 diabetes.
During pregnancy, it is possible for blood glucose levels to reach levels that the insulin produced is insufficient for all of it to be moved into cells (gestational diabetes).

Many people have raised blood glucose levels that are not high enough for a diagnosis of diabetes (prediabetes), which is a wake-up call that the person is en route to diabetes.

Data from National Health and Morbidity Surveys
The prevalence of diabetes in Malaysia’s National Health and Morbidity Survey in 1986 was 6.3%. This increased to 8.2% in the National Health and Morbidity Survey in 1996 and 17.5% in the National Health and Morbidity Survey in 2015.

At the current rate of increase, about one in five Malaysians will be diabetic in 2020. The findings from NHMS 2015 of the overall prevalence of diabetes were:

• There was an increase in overall prevalence with age, with an increasing trend from 5.15% in the 18-19 years age group to a peak of 39.1% in the 70-74 years age group
• The overall prevalence in females was 18.3% and 16.7% in males
• Indians had the highest overall prevalence at 22.1%, followed by Malays at 14.6%, Chinese at 12.0% and Other Bumiputras at 10.7%.
Of the known diabetics, the findings included:
• The prevalence of known diabetes was 8.3% with an increasing trend from 0.7% in the 20-24 years age group reaching a peak of 27.9% in the 70-74 years age group
• The prevalence of known diabetics in the urban areas was 8.7% and 7.2% in the rural areas
• The prevalence in females was 9.1% and 7.6% in males
• Indians had a prevalence of known diabetes at 16.0%, followed by the Malays at 9.0%, Chinese at 7.7% and Other Bumiputras at 6.8%
• 25.1% claimed that they were on insulin therapy and 79.1% on oral anti-diabetic medicines within the past two weeks
• 82.3% had received diabetes diet advice from healthcare personnel
• Healthcare professionals had advised 69.6% to lose weight.
• Healthcare professionals had advised 76.8% to become more physically active or start exercising.
• 79.3% sought treatment at Health Ministry facilities (59.3% at clinics and 20.0% at hospitals) and 18.7% at private facilities (15.1% at clinics and 3.6% at hospitals);
• About 1.5% self-medicated by purchasing medicines directly from pharmacies; and 0.5% were on traditional and complementary medicine.
Of the undiagnosed diabetics, the findings included:
• The prevalence of undiagnosed diabetes was 9.2%, with an increasing trend from 5.5% in the 18-19 years age group reaching a peak of 13.6% in the 65-69 years age group
• Prevalence was 9.2% in females and 9.1% in males;
• Indians had a prevalence of undiagnosed diabetes at 11.9%, followed by the Malays at 9.8%, Others at 8.6%, Other Bumiputras at 8.1% and Chinese at 7.7%.
Of the pre-diabetics (the term used in NHMS 2015 was impaired fasting glucose), the findings included:
• The prevalence was 4.7%;
• There were no statistical differences by age groups, gender and between urban and rural areas;
• Indians had a prevalence of pre-diabetes at 7.7%, followed by Malays at 5.2%, Others at 4.3% and Chinese at 3.8%.
Going forward

Whenever experiencing symptoms such as increased thirst, frequent urination (especially at night), significant fatigue, weight loss, muscle loss, itching in the genitals, recurrent fungal infections, delayed wound healing, and blurred vision, individuals should seek medical attention promptly.

Type 1 diabetes can develop over weeks or even days.

Overweight, obesity, and inactivity often associate with Type 2 diabetes. The overweight comprises 37.3% of the Malaysian population and the obese 12.9%. The estimation shows that 51.6% of the population is physically inactive. Many people with type 2 diabetes are unaware they have the condition because the early symptoms are often non-specific.

The complications of diabetes are multitude and include an increased risk of heart disease and stroke; damage to nerves; damage to the retina in the eyes; kidney disease and failure; foot ulcer; erectile dysfunction; sexual hypo function in women; miscarriage and stillbirth.

Due to delayed detection, diabetics are more likely to present for the first time with complications. The increase in the number of diabetics seeking treatment will increase the country’s health expenditure substantially. Diabetic complications will further increase this.

With about 80% of diabetes patients currently seeking treatment at Health Ministry facilities, the burden to the country will be substantial.
The medical profession recently received directives from the Health Ministry on Ebola virus disease management. This is important for preparedness, although there is no reported case of Ebola infection in Malaysia, as the mortality from Ebola infection is around 50%.

According to the World Health Organization, Malaysia has no operational policy /strategy /action plan for diabetes and the reduction of physical inactivity.
This incongruence is difficult to understand particularly when the diabetes epidemic in the country continues unabated.

Liposuction Believed to be no longer a Slimming Technique

Most of us want to look well-proportioned, but the mirror is often disappointing: saddlebags on the hips, love handles around the waist, spare tyre on the belly. If you’ve had trouble shedding flab the natural way, you might have thought of liposuction to get rid of the excess fat.

But such an intervention is not always the best idea. “Many of those who are interested have misconceptions about liposuction,” says Riccardo Giunta, head of the Hand, Plastic and Aesthetic Surgery Department at the Ludwig Maximilian University of Munich, Germany.

Liposuction is not for people who are overweight and simply want to lose a few kilos just like that. On the other hand, if someone changes their diet and gets lots of exercise and stubborn problem areas remain, liposuction may help.

However, it is anything but risk-free. “A few things can go wrong, when it is done by an insufficiently qualified or inexperienced doctor,” warns Torsten Kantelhardt, a plastic and cosmetic surgery specialist.

Ugly dents may appear if the expert removes too much fat, while liposuction can also lead to swelling and bruising, for example.
Before undergoing such a procedure, patients should seek out as much information as possible about the potential risks and complications associated with liposuction, says Christoph Kranich, of the consumer advice centre in Hamburg.

Patients should also bear in mind one rule of thumb. “The longer the operation lasts and the more fatty tissue is suctioned out, the higher the risk of complications,” Kantelhardt explains.

“The most gentle procedure is water-assisted technology,” Giunta says.
With this method, tissue is removed using a water jet, which also has some local anaesthesia and adrenaline. First, this fluid soaks and loosens fat cells. Then, through a cannula, that tissue is suctioned out along with the fluid, using a vacuum method.

Ultrasound technology is another alternative for liposuction. The problem area is connected to a device that sends off ultrasonic waves to liquefy fat deep down, while keeping the top layers of the skin untouched. In the best-case scenario, the body disposes of this fat on its own, so that it does not need to be suctioned out.
Fat cell suction creates a wound that will heal over time, as the skin tightens up. However, it may happen that the patient’s skin will not adapt well enough and will instead remain baggy. “In such cases, the skin can be tightened through surgery,” Kantelhardt notes.

The cost of liposuction will depend on the size of the problem area in question and on the length of the operation. Potential patients should choose their surgeon with great care, making sure they are properly trained to perform this procedure. – Sabine Meuter/dpa

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